University of Zimbabwe, Biochemistry Department, P. O. Box MP 167, Mt Pleasant, Harare, Zimbabwe.
Mashonaland Central Provincial Health Office, Ministry of Health & Child Care, Harare, Zimbabwe.
BMC Infect Dis. 2019 Dec 19;19(1):1071. doi: 10.1186/s12879-019-4690-z.
Schistosomiasis is known to induce inflammatory immune responses. C-reactive protein (CRP), resistin and P-selectin are serological inflammatory markers that rise during the acute stages of infection. Here, we propose such inflammatory biomarkers have a potential for use in urogenital schistosomiasis diagnostic screening for exposure and infection in preschool-aged children.
As part of a larger study on urogenital schistosomiasis, 299 preschool children aged 1-5 years were included in this cross-sectional study. Parasitological diagnosis was conducted using urine filtration for Schistosoma haemtobium infection, and Kato Katz for S. mansoni infection. Serum levels of P-selectin, resistin, CRP, and antibodies against S. haematobium cercarial antigen preparation (CAP) and soluble worm antigen preparation (SWAP) were measured by ELISA.
Of the 299 participants, 14% were egg positive for S. haematobium. Serology showed 46 and 9% of the participants to have been exposed to S. haematobium cercarial antigens and adult worm antigens, respectively. Levels of P-selectin were significantly higher in participants infected with S. haematobium (egg-positive) than in uninfected participants (p = 0.001). Levels of P-selectin were also higher in those exposed to cercarial antigen than in unexposed participants (p = 0.019). There was a positive correlation between P-selectin and infection intensity (r = 0.172; p = 0.002), as well as with IgM responses to CAP and SWAP (r = 0.183; p = 0.001); (r = 0.333; p < 0.0001) respectively. CRP significantly correlated with IgM responses to CAP (r = 0.133; p = 0.029) while resistin correlated with IgM responses to CAP and SWAP (r = 0.127; p = 0.016); (r = 0.197; p = 0.0004). CRP levels were higher in those exposed to cercarial and adult worm antigens than unexposed participants (p = 0.035); (p = 0.002) respectively, while resistin was higher in participants exposed to cercarial antigen than unexposed participants (p = 0.024).
In this preschool population, P-selectin is significantly associated with urogenital schistosome infection and intensity; hence a potential biomarker for infection diagnosis and disease monitoring. The inflammatory biomarkers (P-selectin, Resistin and CRP) were significantly higher in participants exposed to cercarial antigens than unexposed individuals indicating an underlying inflammatory environment.
血吸虫病会引起炎症免疫反应。C 反应蛋白（CRP）、抵抗素和 P-选择素是血清炎症标志物，在感染的急性阶段会升高。在这里，我们提出这些炎症生物标志物有可能用于学龄前儿童泌尿生殖道血吸虫病的暴露和感染的诊断筛查。
作为泌尿生殖道血吸虫病研究的一部分，共有 299 名 1-5 岁的学龄前儿童参与了这项横断面研究。寄生虫学诊断采用尿过滤法检测 Schistosoma haemtobium 感染，Kato Katz 法检测 S. mansoni 感染。采用 ELISA 法检测 P-选择素、抵抗素、CRP 以及针对 S. haematobium 尾蚴抗原制剂（CAP）和可溶性虫体抗原制剂（SWAP）的抗体水平。
在 299 名参与者中，有 14%的人尿液中含有 S. haematobium 虫卵。血清学检测显示，46%的参与者曾接触过 S. haematobium 尾蚴抗原，9%的参与者曾接触过成虫抗原。与未感染者相比，感染 S. haematobium（虫卵阳性）的参与者的 P-选择素水平显著升高（p=0.001）。与未接触者相比，接触过尾蚴抗原的参与者的 P-选择素水平也更高（p=0.019）。P-选择素与感染强度呈正相关（r=0.172；p=0.002），与 CAP 和 SWAP 的 IgM 反应呈正相关（r=0.183；p=0.001）；（r=0.333；p<0.0001）。CRP 与 CAP 的 IgM 反应显著相关（r=0.133；p=0.029），而抵抗素与 CAP 和 SWAP 的 IgM 反应相关（r=0.127；p=0.016）；（r=0.197；p=0.0004）。与未接触者相比，接触过尾蚴和成虫抗原的参与者的 CRP 水平更高（p=0.035）；（p=0.002），而接触过尾蚴抗原的参与者的抵抗素水平更高（p=0.024）。
在这个学龄前人群中，P-选择素与泌尿生殖道血吸虫感染和感染强度显著相关；因此，它是一种用于感染诊断和疾病监测的潜在生物标志物。与未接触者相比，接触过尾蚴抗原的参与者的炎症生物标志物（P-选择素、抵抗素和 CRP）显著升高，表明存在潜在的炎症环境。
